The enduring legacy of slavery and more than four hundred years of systemic racism have created a public health emergency in the United States. Racial inequality influences public health statistics: in communities of color, rates of COVID-19 and chronic health conditions are higher, which increases the incidence of infant and maternal mortality. Similarly, police violence poses a threat to Black, Brown, and Native American communities.
In response to these statistics, the Anti-Racism in Public Health Act of 2020 is coming to a congressional vote. Please contact your members of Congress to tell them how you feel about their support for the Anti-Racism in Public Health Act of 2020.
Centuries of systemic racism have created significant health disparities for racial and ethnic minority groups. COVID-19 has disproportionately impacted Communities of Color, as the age-adjusted mortality rates for Black, Indigenous, Pacific Islander, and Latinx communities are all at least three times higher than for white communities, but these groups have long experienced worse health outcomes across many other metrics. For example, Black and Brown individuals are more likely than white individuals to report a range of chronic health conditions including asthma, diabetes, heart disease, and HIV/AIDS but are less likely to have health insurance. Similarly, significant racial disparities exist regarding infant and maternal health, as Black women are three to four times more likely to experience a pregnancy-related death than white women. Law enforcement violence also disproportionately kills People of Color and creates significant physical and psychological trauma for marginalized communities. Black and Hispanic people are more likely to be killed by police than white people, while Black and Native American individuals are disproportionately admitted to emergency rooms following police interactions. Black people are also more likely than white individuals to report stress after encounters with police.
These disparate health outcomes are primarily driven by social determinants of health – including social and economic factors, physical environment, and clinical care – rather than genetics or individual health choices. Since housing, education, employment, food, transportation, criminal justice, and many other areas of society directly affect physical and mental health, systemic racism in these areas further entrenches inequitable health outcomes. Some experts suggest that police brutality is itself a social determinant of health, especially for Black Americans. Not only does police brutality increase morbidity by fatally injuring victims, it also traumatizes witnesses; causes stress after racist public reactions; generates financial strain through legal, medical, and funeral bills; and serves as a consistent reminder of the systemic disempowerment and devaluing of Black lives. To fully eliminate racial health disparities, the government must directly address social determinants of health.
The Anti-Racism in Public Health Act of 2020 (H.R. 8178/S.4533) is a historic first step towards fully understanding and addressing the connection between structural racism and public health. Introduced by Senator Elizabeth Warren (MA), Representative Ayanna Pressley (MA-07), and Representative Barbara Lee (CA-13), this bill declares racism a public health crisis, expands research into the public health impacts of systemic racism, and requires the federal government to develop anti-racist public health policy. The bill establishes a National Center for Anti-Racism at the Centers for Disease Control Prevention (CDC) and creates a Law Enforcement Violence Prevention Program within the National Center for Injury Prevention and Control at the CDC. By taking a public health approach to systemic racism and police violence, these programs will help dismantle systems of oppression and eliminate racial disparities in health care. It is time to recognize that racism is itself a public health emergency.
Jewish tradition emphasizes our responsibility to advance racial justice and ensure health care for all people. Jewish tradition teaches that human life has infinite value, regardless of race or ethnicity, and that the preservation of life supersedes almost all other considerations. As Maimonides, a revered Jewish scholar and physician, explains, “it is obligatory from the Torah for the physician to heal the sick” (Commentary on Mishnah Nedarim 4:4). Furthermore, providing health care is not just an obligation of the doctor, but for society as well. For this reason, Maimonides placed health care first on his list of the ten most important communal services a city must offer its residents if the city is to be found worthy for a great scholar to live there (Mishneh Torah, Hilchot De’ot IV:23). The Talmud also teaches that God created humanity out of dust from all over the world: yellow clay, white sand, black loam, and red soil. Therefore, no one can declare to any race or color of people that they do not belong here or that this soil is not their home (Yalkut Shimoni, 1:13). As we work to advance racial justice and ensure that all people can live healthy lives, we must specifically address the public health impacts of systemic racism.